Impact of standard versus cyclic teriparatide and denosumab treatment on trabecular bone score: a post-hoc analysis of a randomized clinical trial
Authors' conclusion
TBS improved similarly with cyclic and standard treatment regimens of TPTD and denosumab over 36 months, however possible differences may have been masked by inadequate study power.
Study context
- Population
- Postmenopausal women with osteoporosis50 completed 36 months
- Participants
- 70 women
- Comparison
- Cyclic TPTD (three 6-month cycles, each followed by denosumab) vs standard TPTD for 18 months followed by denosumab for 18 months
- Cyclicn = 32
- Standardn = 32reference
- Primary endpoint
- Change in TBS (lumbar spine), cyclic vs standard therapy
- Follow-up
- 36 months
Primary result
As reported in the abstract
TBS increase from baseline · 18 and 36 months
| Group | Value | P vs baseline, 18 months | P vs baseline, 36 months | P vs baseline, 18 and 36 months |
|---|---|---|---|---|
| Standard | 1.1% at 18 months; 1.6% at 36 months | p = 0.11 vs baseline | p < 0.11 vs baseline | |
| Cyclic | 2.4% at 18 months; 2.6% at 36 months | both p < 0.05 vs. baseline |
Value
Standard1.1% at 18 months; 1.6% at 36 months
Cyclic2.4% at 18 months; 2.6% at 36 months
P vs baseline, 18 months
Standardp = 0.11 vs baseline
Cyclic— not stated in the abstract
P vs baseline, 36 months
Standardp < 0.11 vs baseline
Cyclic— not stated in the abstract
P vs baseline, 18 and 36 months
Standard— not stated in the abstract
Cyclicboth p < 0.05 vs. baseline
Further findings
Baseline Trabecular Bone Score (TBS) (both groups)
- Similar between groups; mean level, considered partially degraded
- 1.24 ± 0.05
Improvement in TBS category · 36 months
- Participants with improved TBS category (total)
- 17
- Deteriorations to a lower category
- 4
- No difference between groups in TBS category change
Original publication
Impact of standard versus cyclic teriparatide and denosumab treatment on trabecular bone score: a post-hoc analysis of a randomized clinical trial. Osteoporos Int. Published 20 September 2025. doi:10.
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